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Biomedical subjects

V N Acharya

Publications and source records attributed to V N Acharya.

At least 19 recordsLinked to original sources
PubMed1994

Left ventricular function in end stage renal disease--non-invasive assessment in patients on maintenance hemodialysis.

Non-invasive assessment of left ventricular function was performed by echocardiography and radionuclide ventriculography in 17 end-stage renal disease patients on maintenance hemodialysis. Patients with diabetes mellitus, ischemic heart disease and pericardial or valvular heart disease were excluded from the study. Parameters studied on echocardiography were left ventricular internal diameter in diastole (LVIDd), left atrial diameter (LAD), Aortic root diameter (ARD), Left ventricular posterior wall thickness in systole (LVPWs), End diastolic volume (EDV), End Systolic volume (ESV), fractional shortening percentage (FS%) and ejection fraction (EF). Parameters studied on radionuclide ventriculography were Peak ejection rate (PER), Peak filling rate (PFR) and Ejection fraction (EF). Significantly abnormal values for echocardiographic parameters LVIDd, LVPWs, EDV, ESV and FS% were found. On evaluation by MUGA scans, it was observed that the PER was significantly decreased while the PFR and EF did not change significantly.

Adolescent↗
PubMed1993

Effect of iron deficiency anaemia and its treatment on single dose phenytoin bioavailability.

Iron deficiency is a common nutritional deficiency, which leads to structural functional and enzymatic changes in the body that may affect the pharmacokinetics of drugs. The present study in 7 normal volunteers and 8 adult male patients with iron deficiency anaemia (IDA) was done to investigate the effect of iron deficiency and its treatment with total dose iron (TDI) on the bioavailability of a single dose of phenytoin. Phenytoin bioavailability was investigated before and 3 and 28 days after TDI. The bioavailability parameters Cmax, tmax, AUC and 2 h phenytoin concentrations were not significantly different in anaemic patients as compared to normal volunteers before or after treatment, except for an increase in tmax 28 days after TDI treatment.

Adult↗
PubMed1993

Measurement of serum thyrotropin levels using sensitive immunoradiometricassays in patients with chronic renal failure: alterations suggesting an intact pituitary thyroid axis.

Serum thyroid stimulating hormone (TSH) levels were measured in 127 patients with varying grade of chronic renal failure (CRF). Sensitive immunoradiometricassays (IRMA) were used so that small changes in TSH levels if any, could be appreciated, and to see if such alterations exhibit some relationship with those in thyroid hormone levels. Mean serum TSH levels in the patient group of 2.33 microU/ml (0.07-7.3) was significantly higher in comparison to 1.73 microU/ml (0.25-4.6) in normal subjects (p < 0.001). However, they were not significantly different when measured by radioimmunoassay (RIA) as compared to normals. Serum triiodothyronine (T3), thyroxine (T4) and free triiodothyronine (FT3) levels of 72 +/- 32 ng/dl, 7.4 +/- 2.6 micrograms/dl and 2.9 +/- 0.9 pg/ml were significantly lower than in normal subjects, whereas serum free thyroxine (FT4) showed a slight though not significant elevation. When patients were divided in three subgroups according to the degree of renal insufficiency, TSH levels showed a gradual rise with corresponding depression in their T3, FT3 and T4 levels. In 19 patients who were on hemodialysis (HD) and subsequently received successful renal transplantation, most of the thyroid function parameters returned towards the normals with TSH undergoing significant depression from their pretransplant levels as well as from normal levels. The results indicated that a slight but significant elevation in TSH levels could be revealed by sensitive IRMA in patients with CRF. Rising TSH levels with increasing renal insufficiency and its inverse relationship with T3 and T4 levels suggest maintenance of pituitary thyroid axis.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed1993

Comparison of direct radionuclide cystography with micturating cystourethrography for the diagnosis of vesicoureteric reflux, and its correlation with cystoscopic appearances of the ureteric orifices.

Forty-eight patients with strong clinical suspicion of vesicoureteric reflux (VUR) as the cause for their renal disease; were subjected to direct radionuclide cystography and roentgenographic micturating cystourethrography for its detection. Forty-four of them underwent cystoscopy under local anaesthesia to document the position and appearance of the ureteric orifices. Of the 92 kidney-ureter 'units' available for study, 20 had reflux positive on micturating cystourethrography and 22 had direct radionuclide cystography positivity. Two of the three units picked up on direct radionuclide cystography but missed on micturating cystourethrography were severe refluxes up to the renal pelvis. On the other hand, one unit missed on direct radionuclide cystography but picked up on micturating cystourethrography was a lower ureteric reflux. The sensitivity and specificity of direct radionuclide cystography to detect VUR as compared to micturating cystourethrography is 95% and 95.8% respectively. The localization and appearance of ureteric orifices which were classified as per Lyon's classification greatly enhanced the predictive value of determining past or present VUR. Patients with golf-hole orifices placed laterally had 100% incidence of reflux. Thus, combining direct radionuclide cystography with cystoscopy may enhance the predictive value for diagnosis of VUR even higher than a micturating cystourethrography study.

Adolescent↗
PubMed1992

Fine needle aspiration cytology (FNAC) in the evaluation of acute renal allograft rejection.

310 Fine needle aspirations biopsies (FNAB) were performed in sixty-five live related renal donor transplant recipients in a prospective study over 2 years. 82.8% of FNAB were adequate for opinion and there were no complications after the procedure. Methodology used and interpretation of FNACs was as described by Von Willebrand and Hayry. The procedure of FNAC had a sensitivity of 83.3%, specificity of 98.3% and accuracy of 96.1%, and statistically significant (p < .001) correlation was noted between FNAC and Needle biopsy. The increment in lymphoblasts, lymphocytes and score above 3 was suggestive of acute cellular rejection. Increment in monocytes and macrophages above 1% in addition to other cells, was suggestive of acute vascular rejection. FNAC was found to be a safe, simple and easy procedure with high specificity and sensitivity.

Biopsy, Needle↗
PubMed1991

Total and free thyroid hormone levels in chronic renal failure.

The levels of serum total thyroxine (TT4), triiodothyronine (TT3), free T3, (FT3) free T4 (FT4) and thyrotropin (TSH) were measured in 127 clinically euthyroid patients with varying grades of chronic renal failure (CRF); and 97 healthy individuals. They were grouped as: Group I containing 93 patients on conservative management; Group II containing 34 patients on regular dialysis therapy; and Group III (normals). Group I patients showed significant decrease in TT3, TT4 and FT3 levels (p less than 0.001) as compared to Group III, whereas FT4 and TSH values in group I were not significantly altered. TT3, TT4 and FT3 levels reduced as the severity of renal damage increased. Variations in TT3, TT4, FT3, FT4 and TSH levels in Group II patients were similar to those in Group I, except for a decrease in TSH levels (p less than 0.05) as compared to normals. Several thyroid function tests are abnormal in CRF patients, however, finding of normal FT4 and TSH levels would indicate functional euthyroid status.

Humans↗
PubMed1991

Food reduces isoniazid bioavailability in normal volunteers.

Food and drug interaction is a major variable in bioavailability of drugs. Isoniazid is the most common antitubercular drug used in India. We studied the effect of standard Indian breakfast and lunch on the bioavailability of isoniazid in a single dose crossover study in normal male volunteers. The standard breakfast and lunch significantly reduced plasma AUC, Cmax and Kabs values of isoniazid. Isoniazid, thus, should not be administered with food.

Adult↗
PubMed1990

Pattern of renal amyloidosis in western India. A study of 104 cases.

A total of 31,266 autopsies and 1556 renal biopsies were scrutinised over a period of 19 years (1968-1986) retrospectively and prospectively, with an aim to study the incidence and pattern of renal amyloidosis in western India. A total of 104 cases with amyloidosis were detected, 41 from the autopsy series (0.1%) and 63 from biopsies (4%). Secondary amyloidosis was seen in 83.7% and primary amyloidosis in 11.5%. The interval between the onset of predisposing disease and first evidence of amyloidosis varied from 2 months to 31 years. Tuberculosis of various organs was the main cause of secondary amyloidosis (72.4%). Nephrotic syndrome was a common mode of presentation (71.4%). Besides kidneys, which were involved in all cases, the liver, spleen and adrenals were other commonly involved organs at autopsy. Renal failure was the leading cause of death (34.1%).

Adolescent↗
PubMed1989

Acute renal failure due to viperine snake bite as seen in tropical western India.

A wide spectrum of clinicopathological changes have been described in 50 cases of ARF following viperine snake bite studied prospectively over a 15-year period. Disseminated intravascular coagulation (DIC) was seen in 24/50 cases (Russel's viper bite in 62% and Ecchis carinatus bite in 42% of subjects). Histological examination of renal tissue obtained 1.5 days to 8 weeks after the bite revealed proliferative glomerular changes in 17 cases. These were characterized by ballooning of the capillaries, thickening and splitting of glomerular basement membrane (GMB), fibrin thrombi in the capillaries, and mesangial cell proliferation most prominently seen in Ecchis carinatus bites resulting in ARF.

Acute Kidney Injury↗
PubMed1989

Clinicopathological study of acute renal failure following viperine snake bite.

Fifty patients of acute renal failure following Viperine snake bite were studied. Oliguria (100%), local swelling (48%) and bleeding tendencies (42%) were the predominant clinical features encountered. Of the 25 patients in whom detailed coagulation studies were done, 24 patients had disseminated intravascular coagulation (DIC) and 1 had primary fibrinolysis. DIC was commoner with Russell's viper bite (62%) in comparison to Echis carinatus bites (40%). Renal histology obtained in 29 cases revealed tubular necrosis (35%), cortical necrosis (24%) tubular degeneration (17%) and glomerular changes (17%). Ballooning of glomerular capillaries (59%), splitting of glomerular basement membrane (40.7%), swelling of endothelial cells (29.6%), and focal proliferation of mesangial cells (17%) were the significant glomerular changes encountered. 20 (40%) patients succumbed, DIC (50%), irreversible shock (30%) and septicaemia (20%) being the immediate causes of death. Development of oliguria within 24 hours of snake bite and cortical necrosis were associated with higher mortality.

Acute Kidney Injury↗
PubMed1988

Effect of ascariasis and its treatment on drug absorption.

Ascariasis has been reported to impair the absorption of nutrients, vitamin A, and D-xylose, which is corrected on treatment. The effect of ascariasis and its treatment on the absorption of sulphadimidine and isoniazid has been investigated. There was no difference between drug absorption before and after the treatment or in comparison with a normal population.

Ascariasis↗
PubMed1988

Effect of iron deficiency anaemia and its treatment on the absorption and elimination of phenformin.

1. The extent of phenformin absorption and its rate of urinary excretion have been assessed in adult patients with iron deficiency anaemia, a condition which compromises gastrointestinal function. 2. Phenformin (100 mg) was administered orally to patients before treatment, three days after the start of a course of iron treatment (oral 300 mg b.d. or total intravenous iron) and at the end of 28 days, when haemoglobin was over 10 gm%. 3. No significant difference was found between mean total amounts of phenformin and 4-hydroxyphenformin excreted in urine, before treatment or after 3 or 28 days replacement therapy. It is concluded that phenformin absorption is not affected by iron deficiency. 4. In addition, iron deficiency had no significant effect on phenformin elimination half-life.

Adult↗
PubMed1987

Effect of iron deficiency anaemia and its treatment on sulphadimidine absorption.

The effect of iron deficiency anaemia and its treatment on the absorption of sulphadimidine has been investigated in adult patients. The absorption judged by total % of the dose excreted in urine and Cmax, tmax, AUC and Kabs in plasma, was not significantly different before and after iron therapy or correction of anaemia. However, sulphadimidine absorption by the anaemic patients was significantly greater than in normals.

Acetylation↗